DOCSLIB.ORG

Gallium-67 Scintigraphy Evaluation of Therapy in Non-Hodgkin' S Lymphoma

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Gallium-67 Scintigraphy Evaluation of Therapy in Non-Hodgkin' S Lymphoma Gallium-67 Scintigraphy Evaluation of Therapy in Non-Hodgkin' s Lymphoma Massimo Gasparini, Emilio Bombardieri, Massimo Castellani, Carlo Tondini, Lorenzo Maffioli, Liliana Devizzi and Paolo Gerundini Nuclear Medicine Department, Ospedale Maggiore-IRCCS, Milan; Nuclear Medicine Division, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan; and Medical Oncology Division, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy tal approaches, whereas those at low risk may do well with Patients with diffuse large cell lymphoma may achieve complete standard therapy. remission (CR) after chemotherapy, and the time to reach CR may Patients with diffuse large cell lymphoma (DLCL) can be predictive of treatment outcome. Partial remission, or recurrence from CR, is associated with poor survival. Gallium-67 imaging has achieve complete remission (CR) after chemotherapy, and the proven to be useful in evaluating lymphoma patients. In tumor time to reach CR may be predictive of treatment outcome. models, this radiotracer is an indicator of tumor viability.Gallium-67 Partial remission (PR), or relapse of disease after CR, is uptake is seen only inavid and viable lymphoma tissue, not infibrotic associated with poor survival. The possibility of further pre or necrotictissue. Inthisstudy,we prospectivelyassessed the ability dicting outcome during early treatment might lead to a change of this radiotracer to define residual disease. In addition, we evalu in therapy, with a potential improvement in survival. ated the possibility of predicting the clinical outcome in patients with Differentiation of tumor from fibrosis within residual radio diffuse cell lymphoma on the basis of scan positivity during chemo graphic masses represents an important diagnostic problem in therapy. Methods: Thirty-three consecufive patients wfth histologi these patients. The presence ofa residual mass after treatment may cally proven diffuse large cell lymphoma were investigated with 6TGa not always indicateresidual disease (3—5);conventionalradiologic scintigraphy 48—72hr after injection of i85—259MBq 67Ga-citrate for staging and duringfollow-upafter fourto six cycles of intensive studies often show a mass when the patient is in CR (6—8).The chemotherapy. Patients were monitored for a mean of 56.0 mo reverse situation, when the disease has disappeared clinically and (range 7—90mo), and they were restaged using physical examina radiologically but the patient shows recurrence very soon after the tion, CT and all necessary imaging modalities. Results: Patients end of treatment or in due course, is also seen (9). were divided into two groups according to the positMty or negativity CT gives information about tumor size and distribution of of 67@3@scan after four to six cycles of chemotherapy. Of the 33 lesions but is sometimes unable to differentiate fibrosis from patients studied, i4 (42.4%) showed persistent abnormal uptake of active lymphoma(10). MRI seems to have a valuable role in initial 67Ga-citrate after four to six cycles of chemotherapy. In this group, staging (11 ) and in assessing residual disease (12), because active 9 patients(64.2%) died of lymphomaat a mean of 24.3 mo from malignant tissue has been reported to have different signal char presentation with the diagnosis (range 7—7imo). Four patients had actenstics from normal tissues or fibrosis (13—15). no evidence ofdisease at an average of 7i .7 mo after diagnosis, and Several studies have examined the potential use of PET with i patient was considered to be in partial remission. In the second biological tracers for tumor detection (16,17), mostly using group of 19 67Ga-negative patients, afterfour to six cycles of chemo therapy, 4 died and i 5 are alive and considered to be in CR. A enhanced glycolysis of vital tumor cells as defined by fluoro @ statistical analysis of the association between 67(3@ resutts after deoxyglucose (FDG) uptake. Although nonspecific FDG accu four to six cycles of chemotherapy and survival was performed using mulation in macrophages (18) and hypoxia-induced FDG uptake the log-rank test; there was a Statistically algnificant association (19) could be confounding factors, FDG seems to be an attractive between scan results and survival (p = 0.00i25). Conclusion We radiopharmaceutical for monitoring response to therapy. conclude that 67@3@scintigraphy is an excellent predictor of residual Gallium-67 imaging has proved useful for evaluating lym tumor viat@lityin lymphoma patients and that persistent positMty of phoma patients. In tumor models, this radiotracer is an indicator the scan predicts poor outcome and may justify a change in treat of tumor viability (20). Gallium-67 uptake is seen only in avid merit and viable lymphoma tissue, not in fibrotic or necrotic tissue. Key Words galliumscintigraphy; non-Hodgkin's lymphoma chemo There is now convincing evidence that 67Ga scintigraphy has therapy become an important and essential procedure in evaluating J Nuci Med I99@ [email protected]—I590 cancer patients. It is somewhat paradoxical, therefore, that 67Ga has not yet been generally accepted by the nuclear medicine community. 1@1ultidrugchemotherapyhastransformedaggressivenon In this study, we prospectively assessed the ability of 67Ga Hodgkin's lymphoma (NHL) from a fatal disease into one that scintigraphy to define residual disease. In addition, we evalu is often curable (1,2). However, many patients still die ofit, and ated the ability to predict clinical outcome in patients with we need a more accurate method of prospectively identifying DLCL on the basis of scan positivity during chemotherapy. patients with different long-term prognoses. The identification of different risk groups could have important therapeutic MATERIALS AND METhODS implications. Patients at high risk who are not effectively treated with current regimens may benefit from new experimen Patient Selection Thirty-three consecutive patients (16 males and 17 females) with histologically proven DLCL entered the study (working formula ReceivedJul.21, 1997;revisionaccepted Dec.2, 1997. tion—intermediate grade, Group E = 4, Group F = 3 and Group For correspondence or reprints contact: Massimo Gasparini, MD, Nuclear Medicine Department,Pad@neGranelIi, OspedaleMagg@re,IRCCS,ViaFrancescoSforza,35, G = 26). The median age was 47.2 yr (range 14—72yr). The 20122Milano,tta@'. patients were assessed by physical examination and routine labo 1586 THE JOURNALOFNUCLEARMEDICINE•Vol. 39 •No. 9 . September 1998 TABLE I collecting 60 projections in a 360°circular orbit at a rate of 40—45 Patient Characteristics sec per projection. After uniformity correction, 8-mm transaxial, coronal and, in some cases, sagittal tomograms were reconstructed patientsTotal33Sex16MF17HistologyNHL4EF3G26Stage12II7III5IV9SiteCharacteristicNumber of using a medium filter (cutoff frequency = 0.4 pixei ‘)with intermediate characteristics between Sheep and Logan and Chesler and suppresses the high frequencies (Toshiba camera). The Picker three-head images were reconstructed using a Wiener filter. SPECT was used in 16 patients. Abnormal 67Ga tumor uptake was defined as any focal or diffuse area of increased activity in a location incompatible with normal anatomy. CT scans were performed in 22 patients (total 42 examinations) before and after treatment, whereas the other 11 patients were investigated with MRI (29 examinations). The main criterion of a positive CT scan was the presence of an abnormal mass in the body and a change in tumor size over time; CT assessment of lymphoma activity is predicated on anatomic criteria. disease23Aboveof MRI was considered positive for active disease (lesion corn diaphragmBelow posed primarily of active tumor tissue) when an homogeneous diaphragm10Treatment8ChemotherapyChemotherapy active pattern, with low signal intensity on T2-weighted imaging and high signal intensity on Tl-weighted imaging, was present. radiotherapy25Mean + Homogeneous inactive pattern, with low signal intensity on Tl - or T2-weighted imaging corresponded to lesions composed primarily yr.NHLage of patients = 47.2 of fibrosis. = non-Hodgkin'slymphoma. After restaging, the patients were categorized as (a) having achieved CR with no evidence of disease on the basis of clinical, laboratory and imaging studies or (b) having uncertain CR when ratory and imaging studies, including chest radiography, CT, MRI, showing no clinical evidence of lymphoma, but having some lymphangiography, bone marrow biopsy and eventually gastroin persistent abnormality on imaging studies at the site of previous testinal and urographic examinations. disease. Thirty-two patients were treated with polychemotherapy for the The results of 67Ga gallium scintigraphy, CT or MRI were first time at National Cancer Institute of Milan (Italy). One patient matched with clinical findings; an imaging finding that agreed with had been treated for Hodgkin's disease 8 yr before the current clinical status was considered to be either true-positive or true diagnosis. negative. Chemotherapy consisted of cyclophosphamide, Adriamycin, vincristine and prednisone (CHOP) for 18 patients; cyclophosph RESULTS amide, etoposide, Adriamycin, vePesid and prednisone (CEEP) for Of the 75 67Gascans performed, 48 (64%) showed abnormal 5 patients; or Adriamycin, vePesid, Endoxan, and prednisone (first uptake and 27 (36%) were considered negative. In the group of part)—Ara C, bleomycin, vincristine and methotrexate (second positive scans, there was 1 false-positive result,
Load more

Recommended publications
  • A Comparison of Imaging Modalities for the Diagnosis of Osteomyelitis
    A comparison of imaging modalities for the diagnosis of osteomyelitis Brandon J. Smith1, Grant S. Buchanan2, Franklin D. Shuler2 Author Affiliations: 1. Joan C Edwards School of Medicine, Marshall University, Huntington, West Virginia 2. Marshall University The authors have no financial disclosures to declare and no conflicts of interest to report. Corresponding Author: Brandon J. Smith Marshall University Joan C. Edwards School of Medicine Huntington, West Virginia Email: [email protected] Abstract Osteomyelitis is an increasingly common pathology that often poses a diagnostic challenge to clinicians. Accurate and timely diagnosis is critical to preventing complications that can result in the loss of life or limb. In addition to history, physical exam, and laboratory studies, diagnostic imaging plays an essential role in the diagnostic process. This narrative review article discusses various imaging modalities employed to diagnose osteomyelitis: plain films, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, bone scintigraphy, and positron emission tomography (PET). Articles were obtained from PubMed and screened for relevance to the topic of diagnostic imaging for osteomyelitis. The authors conclude that plain films are an appropriate first step, as they may reveal osteolytic changes and can help rule out alternative pathology. MRI is often the most appropriate second study, as it is highly sensitive and can detect bone marrow changes within days of an infection. Other studies such as CT, ultrasound, and bone scintigraphy may be useful in patients who cannot undergo MRI. CT is useful for identifying necrotic bone in chronic infections. Ultrasound may be useful in children or those with sickle-cell disease. Bone scintigraphy is particularly useful for vertebral osteomyelitis.
    [Show full text]
  • Members | Diagnostic Imaging Tests
    Types of Diagnostic Imaging Tests There are several types of diagnostic imaging tests. Each type is used based on what the provider is looking for. Radiography: A quick, painless test that takes a picture of the inside of your body. These tests are also known as X-rays and mammograms. This test uses low doses of radiation. Fluoroscopy: Uses many X-ray images that are shown on a screen. It is like an X-ray “movie.” To make images clear, providers use a contrast agent (dye) that is put into your body. These tests can result in high doses of radiation. This often happens during procedures that take a long time (such as placing stents or other devices inside your body). Tests include: Barium X-rays and enemas Cardiac catheterization Upper GI endoscopy Angiogram Magnetic Resonance Imaging (MRI) and Magnetic Resonance Angiography (MRA): Use magnets and radio waves to create pictures of your body. An MRA is a type of MRI that looks at blood vessels. Neither an MRI nor an MRA uses radiation, so there is no exposure. Ultrasound: Uses sound waves to make pictures of the inside of your body. This test does not use radiation, so there is no exposure. Computed Tomography (CT) Scan: Uses a detector that moves around your body and records many X- ray images. A computer then builds pictures or “slices” of organs and tissues. A CT scan uses more radiation than other imaging tests. A CT scan is often used to answer, “What does it look like?” Nuclear Medicine Imaging: Uses a radioactive tracer to produce pictures of your body.
    [Show full text]
  • INTERPRETATION of the 67Gd PHOTOSCAN
    INTERPRETATION OF THE 67Gd PHOTOSCAN Steven M. Larson, Michael S. Milder, and Gerald S. Johnston National Institutes of Health, Bethesda, Maryland Gallium-67 citrate is used to locate sites of of these investigators was not achieved, several im tumor involvement throughout the body. In or portant observations were made. The distribution of der to make proper use of this new agent, a carrier-free "7Ga was predominantly found within knowledge of the normal ' t.u distribution and the liver, spleen, kidney, and bone in rats. The addi physiological variations is necessary. For this tion of stable gallium caused a progressive increase report, over 400 whole-body rectilinear scans in relative concentration within the skeleton and a using 35 fid/kg "~Ga citrate were reviewed. At relative decrease in soft tissue concentration. As a 48 hr, normal 6~Ga activity is concentrated in result of this early work, ^Ga with a carrier was the axial skeleton, liver, spleen, and around the later evaluated as a bone scanning agent, and it was large joints. Foci of uptake are often seen in while scanning the bones of a patient with Hodgkin's the salivary, lacrimal, and mammary glands. disease that the tumor-specific properties of 67Ga- Activity is also found in the region of the naso citrate were discovered (2). pharynx. Under certain physiological condi The distribution of 07Ga in humans has subse tions, intense localisation may occur within the quently been studied (77-73). When carrier-free breast, bowel, and long bones. These variations 07Ga-citrate is injected intravenously, the majority may mimic malignant tumors.
    [Show full text]
  • GALLIUM SCAN Information Brochure
    GALLIUM SCAN Information Brochure North Shore Radiology & Nuclear Medicine North Shore Private Hospital Westbourne Street, St Leonards 2065 Tel: (02) 8425 3684, Fax: (02) 8425 3688 Nuclear Medicine Physicians Dr Elizabeth Bernard FRACP Dr Paul Roach FRACP INSTRUCTIONS FOR PATIENTS HAVING A GALLIUM SCAN What is it? This is a test which is used to detect a variety of conditions, including infections, abscesses and certain tumours such as lymphoma. How is the test done and how long does it take? The test involves an injection into a vein of a small amount of a radioactive compound called Gallium. A specialised camera is then used to take pictures of your body. On the first day, the test will be explained to you and a technologist will give you the injection gallium (this only takes no more than 15 minutes). You will return two days later for the scan which may take 30-90 minutes depending on what your doctor is looking for. (You are not scanned earlier because it takes several days for any abnormality to appear on the scan.) You may need to return for further scans over the next few days as gallium is normally excreted into the bowel and it may take up to 1 week for the bowel to clear. Is it painful and are there any side effects? No. There are no side effects or reactions from the injection. The injection does NOT contain iodine and is therefore safe to give even if you have had a previous allergic reaction to contrast injections. Although you will be required to keep still during the scan, the procedure itself is completely painless.
    [Show full text]
  • Gallium Study: Performed to Detect Or Localize Areas of Chronic Infection Or Tumors • There Are No Preparations Needed For
    Gallium Study: performed to detect or localize areas of chronic infection or tumors There are no preparations needed for this exam; although it would be beneficial if the patient is well-hydrated and only if it does not interfere with other testing or procedures. If a gallium scan is needed, it should be done before any tests that use barium (such as a barium enema). Taking a medicine (such as Pepto-Bismol) that contains bismuth can also interfere with a gallium scan. In some cases, patients may be required to do a mild bowel prep prior to or upon completion of this study. If the patient is under the age of 50 and has NOT had a hysterectomy, a urine pregnancy test will be required at no charge to the patient. The patient needs to arrive 30 minute prior to the appointment time for the pregnancy test to be administered. If the patient is breast feeding, please consult the department for further instruction. The duration of this exam can range from six to 72 hours. The patient is injected with a radioactive tracer in the vein. The patient returns to the Radiology department six hours after the time of the injection. The patient lies on the imaging table and is scanned from the head to mid-thigh or over a particular area of interest. Imaging takes about 1 hour. The patient returns at 24 hours and again at 48 hours to repeat the scan. The patient may also need to return after 72 hours for another scan. The patient is asked to bring any prior films or reports of x-rays, ultrasound, MRI or CT scans ONLY if the studies were NOT performed at United Regional.
    [Show full text]
  • PET/CT & Nuclear Medicine in Clinical Practice
    The 8 th | Snowmass 2017: PET/CT & Nuclear Medicine in Clinical Practice Friday, February 24, 2017 Westin Snowmass Resort • Snowmass Village, Colorado Educational Symposia TABLE OF CONTENTS FRIDAY, FEBRUARY 24, 2017 Fluoride PET/CT Bone Imaging (Kevin L. Berger, M.D.) ................................................................................................. 221 Bone Scintigraphy (Andrew T. Trout, M.D.) .................................................................................................................. 235 Improving Efficiency in PET/CT Practice (Paul Shreve, M.D.) ......................................................................................... 249 Infection and Inflammation Imaging (Don C. Yoo, M.D.) ................................................................................................ 263 Clinical Molecular Imaging: Beyond FDG and PET/CT (Arif Sheikh, M.D.) ..................................................................... 275 SAVE THE DATES - 2018 Winter Symposia 221 222 INTRODUCTION DIAGNOSTIC METHODS Modalities 18F NaF was one of the original • Planar bone scan agents. In fact, FDA • X-Ray • CT approved 18F NaF for clinical use in • MRI 1972. • SPECT/CT • PET • PET/CT Now, there are many choices to Bone Imaging Agents diagnose a bone metastasis. • 99mTc medronate (MDP) • 99mTc oxidronate (HDP) • 18F FDG • 18F NaF INTRODUCTION 18 INTRODUCTION HOW DOES F NaF WORK? ADVANTAGES OF 18F NaF PET/CT BONE SCANS • 18F produced by proton bombardment of 180, represents a precursor in pathway of 18F for
    [Show full text]
  • Application of Fluorine-18-Deoxyglucose Positron Emission Tomography and Gallium Scan for Assessment in a Patient with Adult-Onset Still’S Disease
    Arch Rheumatol 2016;31(2):180-183 doi: 10.5606/ArchRheumatol.2016.5754 CASE REPORT Application of Fluorine-18-Deoxyglucose Positron Emission Tomography and Gallium Scan for Assessment in a Patient With Adult-Onset Still’s Disease Jing-Uei HOU, Shih-Chuan TSAI, Wan-Yu LIN Department of Nuclear Medicine, Taichung Veterans General Hospital, Taichung, Taiwan ABSTRACT A 53-year-old female patient suffered from pain in almost her entire body, particularly the joints. Chest computed tomography revealed multiple lymphadenopathies over cervical, mediastinal, and axillary areas. A fluorine-18-deoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) revealed increased FDG uptake in many lymph nodes and the spleen. Lymphoma was suspected. However, the result of a biopsy showed no malignancy, and the gallium-67 citrate scan showed no gallium-avid tumor throughout the whole body. Adult-onset Still's disease was diagnosed and the patient responded well to steroid therapy. The follow-up PET/CT six months later showed complete remission of the FDG-avid lesions seen in the previous PET/CT. Our study suggests that FDG PET/CT combined with gallium-67 scan may be helpful in diagnosing patients with adult-onset Still’s disease. In addition, the use of FDG PET/CT alone may be useful for the evaluation of disease distribution, disease activity, and therapeutic response. Keywords: Adult-onset Still’s disease; fluorine-18-deoxyglucose; gallium-67; positron emission tomography/computed tomography. Adult-onset Still’s disease (AOSD) is an CASE REPORT inflammatory disorder of unknown cause. “Still’s disease” was first described in children by George A 53-year-old female patient suffered from pain Still in 1896.1 In 1971, the term “Adult-onset over most of her body, particularly the joints and Still’s disease” was used to describe patients the throat.
    [Show full text]
  • Gallium Imaging What to Expect During the Test • the Test Will Take 2 - 3 Days
    Nuclear Medicine Patient Information Gallium Imaging What to expect during the test • The test will take 2 - 3 days. Welcome to VCU Health Nuclear Medicine. We are Day 1 located in the Gateway Building, 2nd floor, 1200 East . A needle (IV) will be placed in a vein (intravenous Marshall Street. Our hours of operation are Monday catheter). through Friday, 7 am to 5 pm. Advanced scheduling is . A radioactive tracer will be administered through required for all nuclear medicine exams. Please review the IV. the following information about your test. Please call . You may go on with normal activities in between (804) 828-6828 to schedule your test or if you have any the injection and scan (eat and drink as normal). questions about your nuclear medicine exam. Day 2 (48 hours after injection) . You will lie down while the camera takes pictures What is it? of your whole body and possibly a SPECT (360 Imaging to detect certain types of infection, certain degree picture of your body) for 1 – 2 hours. inflammatory diseases or tumors. The images will be checked for quality by our Physician and more pictures may be needed. Why are you having this test? Day 3 (72 hours after injection) A gallium scan is done to: . You will lie down while the camera takes pictures • Detect the source of an infection that is causing a of your whole body and possibly a SPECT (360 fever (called a fever of unknown origin). degree picture of your body) for 1 – 2 hours. • Detect an abscess or certain infections, .
    [Show full text]
  • 4Th Quarter 2001 Medicare a Bulletin
    In This Issue... Medicare Guidelines on Telehealth Services Benefit Expansion, Coverage and Conditions for Reimbursement of These Services ............... 5 Medicare eNews Now Available Join Florida Medicare eNews Mailing List to Receive Important News and Information ........ 9 Expansion of Coverage on Percutaneous Transluminal Angioplasty Coverage Expansion and Claim Processing Instructions for Hospital Inpatient Services ..... 12 Skilled Nursing Facility Consolidated Billing Clarification to Health Insurance Prospective Payment System Coding and Billing Guidelines .............................................................................................................................. 15 Final Medical Review Policies 10060, 55873, 67221, 71250, 74150, 84155, 85007, 88141, 92225, 93303, A0430, G0030,G0104, G0108, J1561, J1745, J9212, and M0302 ...................................... 22 Outpatient Prospective Payment System Update and Changes to the Hospital Outpatient Prospective Payment System ...................... 87 Bulletin Reader Survey Provide your Comments and Feedback on the Medicare Part A Publication and/or our Provider Web Site ................................................................................................................ 103 Features From the Medical Director 3 he Medicare A Bulletin should be shared with all Administrative 4 T health care practitioners and General Information 5 managerial members of the General Coverage 11 provider/supplier staff. Publications issued after End Stage Renal Disease 13
    [Show full text]
  • Gallium Scan
    Gallium Scan What to expect at arrival: Please arrive 15-30 minutes prior to the appointment. The first place to go after arriving is admissions. The physician’s office should have provided a written order to the patient. Please take the order to admissions for registration. After checking in, the next stop will be the Radiology desk. The exam should start quickly from the scheduled time. Since Northeast Georgia is a major medical center there are emergencies that could arise that might extend wait time. Please try to be patient and be assured that we will begin your procedure as quickly as possible. What is Nuclear Medicine? Nuclear Medicine is a radiology modality that uses radiopharmaceuticals to image the body’s anatomy and physiology. The images are obtained after an intravenous injection or an oral administration of the radioactive pharmaceutical. Depending on the study, the images can take 20 to 30 minutes or could take a few hours or multiple days, depending on the study. The radiation from the pharmaceuticals is minimal, similar to an x-ray. Patient Prep: There are no restrictions prior to a Gallium Scan. The day before the exam the patient needs to take a light laxative like Dulcolax. The patient can eat, drink, and take medications prior to the injection and afterward. Please let the technologist know if there is any possibility that you may be pregnant. Your Gallium Scan: When you are brought to the Nuclear Medicine department, a technologist will verify the orders and patient identification. A technologist will ask a series of questions and explain the procedure.
    [Show full text]
  • RADIOLOGY HELP DOCUMENTS Procedures and Preps
    RADIOLOGY HELP DOCUMENTS Procedures and Preps YOUR HEALTH : OUR MISSION This document is designed to be a tool to assist you with Pre-Medication Guidelines for Contrast Allergies, Creatinine Requirements, Interventional Procedures and Biopsies, Clinical Indication Guidelines and Patient Preps. Scheduling Same day, outpatient exam: Contact Radiology at 605-882-7770 A future outpatient exam: Contact Central Scheduling at 605-882-7690 or 882-5438 or 882-5448 If a patient needs pre-medication for a previous contrast reaction you need to date and sign and obtain the pre-medication for the patient—the “Contrast Reaction Prophylaxis Suggestions for Premedication” *Fax requests for Oral Medications to the Campus Pharmacy at 605-882-7704, M-F 0830-1700, other hours to Main Pharmacy at 605-882-7694 *Fax Requests for Injectable Medications to Central Scheduling 605-882-6704 • Reports will still continue to come to the appropriate printers in all patient care areas • Reports can be accessed in CPSI, Chartlink, PACS and www.plhspacs.com • ER reports will be routed to the ED printer 1. Stat reports are 30 minutes or less 2. Inpatients and ASAP 4 hours or less 3. Routine outpatient reports are 24 hours from the time the exam is scheduled • Keep in mind, if an exam from any outside or attached clinic (Cardiology, Urology, Nephrology, Cancer Center, GLO, Dr. Jones, Brown Clinic, Sanford Clinic, Hanson/Moran Eye Clinic, Innovative Pain Clinic and VA Clinic) is ordered, the results will be available 24 hours from the time the exam is scheduled. If the patients follow up appointment to see the clinician and review the results is less than 24 hours from the time the exam is conducted, be sure to indicate this on the order so we can submit as an ASAP order.
    [Show full text]
  • Scintigraphic Localization of Lymphatic Leakage Site After Oral Administration Ofiodine-123-IPPA
    ACKNOWLEDGMENTS 13. Lin WY, Lan JL, Cheng KY, Wang SJ. Value of gallium-67 scintigraphy in monitoring the renal activity in lupus nephritis. Scan J Rheum 1998:27:42-45. This study was supported in part by a grant from the Institute of 14. Cruzado JM. Poveda R. Mana J. et al. Interstitial nephritis in sarcoidosis: simultaneous Nuclear Energy Research and National Science Council, Republic multiorgan involvement. Am J Kidney Dis 1995:26:947-951. of China (NSC 87-2314-B-075A-003). 15. Pagniez DC. MacNamara E, Beuscart R, Wambergue F, Dequiet P. Tacque! A. Gallium scan in the follow-up of sarcoid granulomatosus nephritis. Am J Nephrol 1987:7:326-327. REFERENCES 16. Wood BC. Sharma JN, Germann DR, Wood WG, Crouch TT. Gallium-67 citrate 1. Steinberg AD, Steinberg SC. Long-term preservation of renal function in patients with imaging in noninfectious interstitial nephritis. Arch Inlern Med 1978:138:1665-1666. lupus nephritis receiving treatment that includes cyclophosphamide versus those 17. Bakir AA, Lopez-Majano V, Hryhorczuk DO. Rhee HL, Dunca G. Appraisal of lupus treated with prednisone only. Arthritis Rheum 1991:34:945-950. nephritis by renal imaging with gallium-67. Am J Med 1985:79:175-182. 2. Felson DT. Anderson J. Evidence for the superiority of immunosuppressive drugs and 18. Tsan M. Mechanism of gallium-67 accumulation in inflammatory lesions. J NucíMed prednisone over prednisone alone in lupus nephritis. N Engl J Med 1984;311:1528- 1985:26:88-93. 1533. 19. Tsan M, Scheffel U. Gallium-67 accumulation in inflammatory lesions. J NucíMed 3.
    [Show full text]